MATCH-D Medication Appropriateness Tool for Comorbid Health conditions during Dementia

WACHA
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Preventative medications

Preventative medication is defined as medication to prevent a future serious event or delay the progression of a comorbidity.

Expert consensus is that these practices are recommended in the care of people with dementia

Early Stage Dementia

When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:

  • functionality as the most important factor

  • the potential benefits weighed against the actual harm

  • potential for side effects

  • actual side effects

  • the risks of polypharmacy

  • the administration burden

  • maximise quality of life rather than prolong survival

  • continue annual influenza vaccines indefinitely

Mid Stage Dementia

When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:

  • functionality as the most important factor

  • the potential benefits weighed against the actual harm

  • potential for side effects

  • actual side effects

  • the risks of polypharmacy

  • the administration burden

  • maximise quality of life rather than prolong survival

  • continue annual influenza vaccines indefinitely

Late Stage Dementia

When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:

  • functionality as the most important factor
  • the potential benefits weighed against the actual harm
  • potential for side effects
  • actual side effects
  • the risks of polypharmacy
  • the administration burden
  • maximise quality of life rather than prolong survival
  • use less stringent targets for blood glucose
  • only use diuretics for symptomatic management of heart failure
  • cease antihypertensive agents
  • cease lipid-lowering medications
  • cease medications to manage osteoporosis
  • cease anti-platelet, anti-coagulants and anti-thrombotic agents
  • cease all medications that do not also provide tangible symptom relief
  • cease medications that have a longer potential time to benefit than the person’s likely prognosis

Expert consensus is that these practices are NOT recommended in the care of people with dementia

Early Stage Dementia

When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:

  • cease all medications that do not also provide tangible symptom relief
  • cease anti-platelet, anti-coagulants and anti-thrombotic agents
  • cease medications to manage osteoporosis
  • cease antihypertensive agents

Mid Stage Dementia

When prescribing medications intended to modify the risk of a future event for a person living with dementia, health professionals should consider:

  • cease medications to manage osteoporosis
  • cease antihypertensive agents

Why do we need the MATCH-D criteria?

Most people living with dementia have at least one other health condition. They often use medications to manage their other health conditions, but we don’t have much information to guide us on whether this is appropriate. Information to help us optimise medication use for older adults generally are helpful, but people living with dementia have specific needs as they are living with a progressive life-limiting condition.

About MATCH-D

The MATCH-D statements are in the broad themes of preventative medication, symptom management, disease progression, psycho-active medication, treatment goals, principles of medication use, side effects, and medication reviews.

Research Team

The MATCH-D criteria was developed by an interprofessional team of Australian researchers. Dr Amy Theresa Page, Dr Kathleen Potter, Professor Rhonda Clifford and Associate Professor Christopher Etherton-Beer at the University of Western Australia and Professor Andrew McLachlan at the University of Sydney.

Research Centre

WA Centre for Health and Ageing, University of Western Australia Centre for Optimisation of Medicines, University of Western Australia

Published Research

The development of the MATCH-D is published research is available in the Internal Medicine Journal.

The enablers and barriers are published in the BMJ Open.

 

The systematic review that informed the MATCH-D criteria and the protocol are also published.

 

The publications are Open Access, meaning they are available free of charge.

Download files

MATCH-D Criteria

Checklists – Health professional use

PDF – Early stage, Mid stage, Late stage

DOCX – Early stage, Mid stage, Late stage